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JNCI Journal of the National Cancer Institute 2001 93(21):1600-1602; doi:10.1093/jnci/93.21.1600
© 2001 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 93, No. 21, 1600-1602, November 7, 2001
© 2001 Oxford University Press

COMMENTARY

Sex, Smoking, and Cancer: a Reappraisal

Thomas V. Perneger

Affiliations of author: Institute of Social and Preventive Medicine, University of Geneva Medical School, and Quality of Care Unit, Geneva University Hospitals, Switzerland.

Correspondence to: Thomas V. Perneger, M.D., Ph.D., Quality of Care Unit, Geneva University Hospitals, CH-1211 Geneva 14, Switzerland (e-mail: thomas.perneger@hcuge.ch).


   INTRODUCTION
 
Several studies (1–4) have reported that the relative risk of cancer in smokers, compared with nonsmokers, is greater in women than in men. These results have led to speculations about the biologic mechanisms underlying this difference, such as a molecular interaction between sex hormones and tobacco carcinogens. The news media have echoed widely such results, perhaps because anything suggesting that women and men are inherently different strikes a chord among the public.

In this commentary, I suggest that the evidence from these studies is interpreted incorrectly, because of misunderstandings about the meanings of relative risk versus absolute risk and the meanings of statistical interaction versus biologic interaction.


   RELATIVE RISK VERSUS ABSOLUTE RISK
 
To present my argument, I will use data from the study by Castelao et al. (4) that compared smoking habits of case patients diagnosed with bladder cancer with smoking habits of sex-matched community control subjects. In this well-conducted . . . [Full Text of this Article]


   STATISTICAL INTERACTIONS
 

   CAUSAL DISEASE PATHWAYS
 

   A WAY OUT?
 

   NOTES
 

   REFERENCES
 

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